Treatment of Venous Insufficiency & Varicose Veins

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ELVeS™

ELVeS™ – Endo Laser Vein System – is a minimally-invasive laser treatment for Incompetent Saphenous and Accessory Veins – a problem which often leads to the formation of varicose veins. ELVeS™ takes approximately 30 minutes and requires only local anesthesia – allowing patients to walk home after treatment. With virtually instant relief from Venous Reflux and Venous Hypertension, patients can return to their normal lifestyle and activities immediately following treatment.

Treatment in less than an hour in office with no general anesthesia or hospitalization.

Up to 98% success rate.

Immediate relief of symptoms.

Return to normal activity immediately – with little or no pain.

No scars.

Here’s what to expect from the ELVeS™ procedure:
During the procedure, a tiny puncture is made and a small catheter is inserted into the defective varicose. Laser energy is directed at the varicose vein causing it to shrink and eventually close, discontinuing the blood flow through it, causing blood to be diverted into the surrounding healthy veins and eliminating the bulging appearance of the varicose vein. Once closed, pressure within the Incompetent Vein decreases and normal circulation is gradually restored, vastly improving problematic symptoms and vein appearance.

ELVeS™, performed under local or regional anesthesia , is an office-based procedure for Venous Insufficiency and Varicose Veins, received FDA approval in January 2002

Step 1: Ultrasound map out of affected vein.Step 2: Local anesthetic is applied.Step 3: A thin laser fiber is inserted through a tiny entry point, usually near the knee.Step 4: Laser energy is delivered to seal the faulty vein.

Walking immediately after the procedure is encouraged. There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary.

ELVeS™ procedures and applications:

ELVeS PL offers the optimum treatment solution for an effective and gentle endovenous laser therapy and is setting new standards for patients and users.

The Biolitec ELVeS PL System features a patented design for a safe and simple approach – performing endovenous laser therapy has never been more convenient.

Delivering homogenous laser energy at 1470 nm based on a unique and patented distal design, ELVeS PL minimizes the risk of vein perforations and assures high echogenic visibility.

The 1470 nm laser energy is preferentially absorbed in the intracellular water of the vein wall and in the water content of blood. The irreversible photo-thermal process induced by the laser energy results in a complete occlusion of the treated vein.

FAQS about ELVeS™ for varicose & spider veins:
What is the recovery time for laser treatment? Normal daily activity can be resumed immediately following the procedure and walking is encouraged; just avoid rigorous activities such as gym workouts.

How long is a procedure? The complete procedure takes about 20-30 minutes.

What are the common side effects of laser therapy? There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary.

Numbness due to nerve injury can occur after Endovenous laser treatment and though the condition is usually temporary it can be irreversible. Like any removal of the larger veins, if the deep vein system is damaged, removal of the problem vein may worsen existing conditions.

Endovenous laser treatment should not be performed on those who are pregnant, have poor circulation or abnormalities in leg arteries, those who suffer from lymphedema, skin infections, or blood clotting defects, or older individuals that are at high risk for surgery.

RADIOFREQUENCY CLOSURE

Performed under local or regional anesthesia on an out-patient basis, radiofrequency closure was approved by the Food and Drug Administration in March of 1999. During the procedure a tiny puncture is made and a small catheter is inserted into the defective vein. The catheter then delivers radio frequency energy to the vein wall, causing the vein to shrink and seal shut. Once the vein is closed, neighboring healthy veins take over to restore normal circulation.

Once the procedure is completed, external compression is applied to the treated areas and patients are encouraged to wear elastic bandages and support stockings for a few days. Patients normally return home the same day of surgery and can return to work within a few days.

Benefits of radiofrequency closure:

With less bruising and pain radiofrequency closure, is known to produce better cosmetic results than surgical procedures like ligation and stripping.

Outpatient treatment in office with local or general anesthesia.

Up to 90% of the treated veins remain closed and free from reflux.

Relief of symptoms.

Return to normal activity within 1-2 days – with little or no pain.

Good cosmetic outcome with minimal or no scarring, bruising or swelling.

FAQ about radiofrequency closure:

What is the recovery time for radiofrequency closure treatment? Many patients can resume normal activities immediately. A regular walking regimen is suggested though strenuous activities like heavy lifting and prolonged periods of sitting/standing should be avoided. For those into sports and heavy lifting, a delay of 5-7 days is suggested.

Are there any potential risks and complications associated with radiofrequency closure? As with any medical intervention, potential risks and complications exist with the Closure procedure. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the Closure procedure at the consultation , and can be reviewed in the safety summary. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and/or skin burn.

How long does radiofrequency closure take? Radiofrequency closure procedure takes approximately 45-60 minutes. After the procedure, patients are observed for an 1 hour and then discharged home.

Possible risk and complications of radiofrequency closure:

Numbness due to nerve injury can occur and though the condition is usually temporary, it can be irreversible. Published results show a high early success rate with very low recurrence rates. Patient satisfaction is high with 95% of patients reporting that they would recommend the procedure to a friend. Like any removal of the larger veins, if the deep vein system is damaged, removal of the problem vein may worsen existing conditions.

Radiofrequency closure should not be performed on those who are pregnant, have poor circulation or abnormalities in leg arteries, those who suffer from lymphedema, skin infections, or blood clotting defects, or older individuals that are at high risk for surgery.

ENDOVENOUS CHEMICAL ABLATION

Also known as ultrasound-guided sclerotherapy, endovenous chemical ablation is another treatment alternative to surgical removal of varicose veins. During this procedure, a sclerosant solution (a chemical irritant) is injected into the vein while the injection process is observed on an ultrasound screen. The physician can visualize the origin of the vein and directly treat that source causing gradual shrinking of the vein. Prior to ultrasound-guided therapy, the only treatment for large varicose veins was surgical stripping and ligation. Endovenous chemical ablation causes the vein to collapse and seal shut, in much the same way as endovenous thermal ablation, and can be performed with liquid or foamed sclerosants. This procedure is also usually performed in a doctor’s office and generally does not even require local anesthesia. It is not uncommon for a leg wrap or prescription compression stocking to be placed on the treated leg for one to three weeks. Patients are encouraged to walk immediately after the procedure and resume most normal activity right away. Most individuals are able to return to work the next day. Results at our office utilizing u Endovenous Chemical Ablation have shown resolution of the large varicose veins in over 90% of the patients treated.

FOAM SCLEROTHERAPY

Performed on both reticular veins as well as larger varicose veins, foam sclerotherapy is a new approach to conventional sclerotherapy. Mixing a sclerosant detergent with air, a foam is created with a consistency very similar to that of shaving cream. Unlike a liquid sclerosing agent, the foams thicker attribute allows it to remain in contact with the vessel wall for a prolonged period after injection, which enables the treatment of larger varicose veins.

ULTRASOUND GUIDED SCLEROTHERAPY

Ultrasound guided sclerotherapy is used to direct the sclerosant agent more precisely into the damaged vein, permitting the injection of larger veins that once required more invasive treatments.

MICROPHLEBECTOMY

Often varicose veins near the surface of the skin are too large to treat with sclerotherapy and are too small to treat with laser ablation or EVLT. Microphlebectomy is a surgical procedure that allows the removal of short segments of varicose veins through tiny incisions. Normally performed under local anesthesia, tiny incisions are made over the designated veins and are then removed using specially designed instruments. Microphlebectomy is an office-based procedure and can be performed on most varicose veins, with no need for stitches and minimal to no scarring.

Once the procedure is completed, external compression is applied to the treated areas and patients are encouraged to wear elastic bandages and support stockings for a few days. Patients normally return home the same day of surgery and can return to work within a few days.

BENEFITS OF MICROPHLEBECTOMY:

Minimally invasive

Usually only requires local anesthesia to numb the skin over the vein

Performed through a series of small punctures

It is frequently used in combination with sclerotherapy (if a portion of the vein’s course goes deeper under the skin’s surface)

Little or no down time — usual daily activities resumed immediately following the procedure

Compression dressing usually worn for one week following the procedure

Patients asked to avoid strenuous activities for one week

SURGICAL LIGATION AND STRIPPING

While surgical ligation and stripping has been practiced for many years, it is no longer a recommended method of treatment unless medically necessary. It has been replaced by minimally invasive technologies, such as laser and radiofrequency ablation and ultrasound-guided sclerotherapy.

During surgical ligation faulty valves in the varicose vein are isolated and tied off, causing blood circulation to flow into healthy veins adjacent to it. Surgical stripping removes the vein entirely due to extensive valve failure. Today, minimally invasive surgeries are just as effective, with a 90% success rate with good to excellent results. Such procedures can be performed in office with minimal to no incapacity under local anesthesia and allow for immediate resumption of activity. Surgical ligation and stripping cannot be performed in office.

Possible risk and complications of surgical stripping & ligation:

As with any vein therapy, new varicose veins may develop over time. A 50%-60% recurrence rate is reported in long-term follow-up. The most common complications that can arise are swelling, bleeding, scarring, and the appearance of new spider veins.